Video-Based STD Patient Education

The video-based STD education program was designed to
improve the health behaviors of patients seeking treatment from a STD clinic in
the South Bronx. The video-based intervention
program included a 20-minute video that modeled ways in which viewers could
overcome barriers to consistent condom use. Two versions of the video
were made, with each version made to target a different audience: Let’sDo Something Different, which was aimed
at a primarily African American audience,and PorqueSi, which was aimed at a primarily Latino audience. The studies described
below found that the video intervention had a positive impact on condom coupon
redemption, knowledge about STDs/HIV and perception of risk, and attitudes
about condom use. Condom use was not measured.

DESCRIPTION OF PROGRAM

Target population: Patients seeking
treatment for symptoms of a sexually transmitted-disease from a STD clinic in South Bronx.

This
video-based intervention program was designed to help patients overcome
barriers to condom use. The program consisted of an information session,
ranging from 20 minutes to 40 minutes in length depending on whether patients
received either the video and facilitator intervention or the video
intervention alone. The interventions took place before the participant was
evaluated by a doctor at the clinic. In groups of three to eight, patients were
shown a culturally-specific video which demonstrated how patients could
overcome barriers to condom use. Patients who were assigned to the video-only
intervention were then free to go, while patients assigned to the facilitator
condition then took part in small group, gender-specific information session.
The facilitator sessions were led by members of the research team, who used the
video as an introduction to correct misinformation and provide patients with
negotiating tactics to use with partners to promote consistent condom use, and
condom options.

Evaluated population: 3,348 African American and Hispanic men and women over the age of 17
who sought treatment from a STD clinic that served the South
Bronx were randomly assigned to either the video only intervention
or the video and facilitator intervention. Participants were either African
American (60%) or Hispanic (40%), with women making up 40 percent of the
sample. The average participant age was 29.1 for African American men, 31.5 for
Hispanic men, 28.8 for African American women, and 30.2 for Hispanic women. The
majority of participants had lived in the US for at least ten years.
Fifty-four percent of the participants were diagnosed with a sexually
transmitted disease during the study visit.

Approach: Patients
were recruited into the study during an initial visit and were invited back to
receive more information on a randomly assigned day. As it was difficult for
researchers to provide both treatment conditions and the control condition
every day that the clinic was open, certain days were designated for each
condition and patients were then randomly assigned a condition depending on
what day they were told to come to the clinic. All patients, regardless of
which condition to which they were assigned, received the routine disease
prevention information regularly provided by the clinic.

The
researchers collected data using an intake survey that evaluated the
participants’ sociodemographic characteristics and
sexual-risk behaviors and practice histories. Condom acquisition was measured
by a system of coupon redemption. After leaving the clinic, all participants
were given a coupon for free condoms at a pharmacy several blocks from the
clinic. When coupons were redeemed, the pharmacist on duty noted the race
and gender of the participant.

Results: Participants who watched the video and attended a discussion session were
more likely to redeem their coupons for condoms (36.9% redemption rate) than
participants in the video-only group (27.6% redemption rate) and those in the
control group (21.2% redemption rate). This pattern of coupon-redemption was
consistent when looking at the data by gender and race, with the exception that
African American women were less likely to redeem their coupons after watching
the video only than African American women in the control group.

The
authors note a few limitations with their study design. First, the study’s authors used condom coupon redemption as a proxy
for condom use, which may be problematic as condom redemption may not
necessarily translate into actual condom use. Further, the study design did not
study the effects of a facilitator-led discussion only. Another
limitation is that analyses were not conducted by age, so effectiveness for
youth as a subgroup is not known.

Evaluated population: Authors used a
subsample of the sample population described above to assess changes in
attitudes and knowledge after receiving one of the three interventions. The subsample was comprised of 1653 African American
and Hispanic men and women over the age of 17 randomly chosen from the sample
described above.

Approach:
In addition to the intake survey that evaluated all participants’ sociodemographic characteristics and sexual risk behaviors
and practice histories, participants chosen to participate in this subsample
study were also administered a survey that evaluated STD- and condom-related
knowledge, positive attitudes about condom use, and perceived HIV/STD risk
before and after their assigned intervention. The method for measuring condom
acquisition is described above.

Results: When compared with the control group, participants who watched the video
experienced an approximate 40% gain in STD- and condom-related knowledge, an
approximate 27% increase in positive attitudes about condom use, and an
approximate 11% gain in perceived HIV/STD risk. Though the group that
watched the video and also participated in a facilitator discussion experienced
the greatest increase in perceived HIV/STD risk (an approximate 26% increase)
and self-efficacy (an approximate 33% increase) over the control group, there
were no other significant benefits to knowledge and attitudes about STDs and
condoms above and beyond the group that only watched the video.